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Magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) has revolutionized our ability to detect and monitor <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> pathology <jats:italic>in vivo<\/jats:italic>. Proton density, T<jats:sub>1<\/jats:sub> and T<jats:sub>2<\/jats:sub> can provide <jats:italic>qualitative<\/jats:italic> contrast weightings that yield superb <jats:italic>in vivo<\/jats:italic> visualization of central nervous system tissue and have proved invaluable as diagnostic and patient management tools in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>. However, standard clinical <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> methods are not specific to the types of tissue damage they visualize, and they cannot detect subtle abnormalities in tissue that appears otherwise normal on conventional <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>s. Myelin water imaging is an <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> method that provides <jats:italic>in vivo<\/jats:italic> measurement of myelin. Histological validation work in both human brain and spinal cord tissue demonstrates a strong correlation between myelin water and staining for myelin, validating myelin water as a marker for myelin. Myelin water varies throughout the brain and spinal cord in healthy controls, and shows good intra\u2010 and inter\u2010site reproducibility. <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> plaques show variably decreased myelin water fraction, with older lesions demonstrating the greatest myelin loss. Longitudinal study of myelin water can provide insights into the dynamics of demyelination and remyelination in plaques. Normal appearing brain and spinal cord tissues show reduced myelin water, an abnormality which becomes progressively more evident over a timescale of years. Diffusely abnormal white matter, which is evident in 20%\u201325% of <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients, also shows reduced myelin water both <jats:italic>in vivo<\/jats:italic> and postmortem, and appears to originate from a primary lipid abnormality with relative preservation of myelin proteins. Active research is ongoing in the quest to refine our ability to image myelin and its perturbations in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> and other disorders of the myelin sheath.<\/jats:p>","DOI":"10.1111\/bpa.12645","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T01:55:30Z","timestamp":1540864530000},"page":"750-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["Myelin water imaging to detect demyelination and remyelination and its validation in pathology"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9785-6918","authenticated-orcid":false,"given":"Cornelia","family":"Laule","sequence":"first","affiliation":[{"name":"Radiology University of British Columbia Vancouver BC Canada"},{"name":"Pathology &amp; Laboratory Medicine University of British Columbia Vancouver BC Canada"},{"name":"Physics &amp; Astronomy University of British Columbia Vancouver BC Canada"},{"name":"International Collaboration on Repair Discoveries (ICORD) University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.R. 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